Refusing Patients' Requests: Can it be done?

Boog'sCRRN246, RN · May 15, 2011

Hello. I am a 24-year-old student considering beginning the pursuit of a career in nursing( R.N). I have read many threads about the life of a nurse- some claiming it to be pleasant, while others speak negatively about the profession. I am posting this new thread( which by the way is the first thread I have ever posted in my entire life lol) because I read a thread that wrote about how one nurse was annoyed that his patient repeatedly pushed the buzzer for trivial items such as a desire to have the light turned on, to have the phone handed to him, and so on and so forth. MY QUESTION FOR ALL OF YOU EXPERIENCED NURSES IS THIS.Can a nurse simply ignore a patient at times?Does the aforementioned nurse have to hand the telephone to the patient every time he asks for it? (keep in mind that the telephone is only inches away from his bed and the patient is perfectly capable of getting it himself.) ARE THERE TIMES WHEN A NURSE CAN REFUSE A PATIENTS' NON-MEDICAL RELATED REQUEST? SHARE YOUR STORIES.

You can't ignore them, but you can make it clear to the patient that if they are perfectly capable of doing for themselves, that is what needs to be done. I work in Rehab and the majority of patients know they are there to learn how to function for themselves, so most don't ask for frivolous things, but some do. I just ask "Who will do this for you when you go home?" and they usually get the point.

FLArn · May 15, 2011

I have not worked in the hospital but in the skilled nursing units in SNFs we routinely set our rehab patients up so they can reach and do whatever they can for themselves. I would think it should be the same in the acute setting. Put the items they need in easy reach (so there will be no stretching across to reach things at a risk of falling etc) and gentle reminder that in order to get better and go home they need to do what they can for themselves. For legitimate needs, try to group things in a single visit, do them and set a time to come back and help with other things.

FancypantsRN · May 15, 2011

I have never refused per se but I have told the pt something along the lines of..."Ok, what do you need to be set for the next hour, I will check on you again then". Sometimes, they still don't get it. What I think is funny is when the object they are requesting is actually closer to them (on their lap) than the call bell. Or they magically can't hold a water cup but they can make a cell phone call *shrugs shoulders*.

heartflutter, ADN, BSN · May 15, 2011

I work with several dementia patients who request to be toileted every five minutes. If their care plan states every two hours, I take them every two hours. If I toilet people constantly, I'd be neglecting my other patients that want to go to bed, eat, be changed, etc. Sometimes you have to ignore it because the reassurance you give a dementia patient will often be forgotten and it will drive you nuts!

StrwbryblndRN · May 15, 2011

I agree with the above posts.

There are some nurses who will vent about the "lazy" pt but not say anything to them. Some shrug and just do. It is all in how you handle it.

We get some frequent fliers that will never get "it". I accept it for what it is.

Flo., BSN, RN · May 15, 2011

I have been know to tell some people that are being ridiculous that maybe we should start looking into long term care options. Usually results in a miraculous recovery.

Esme12, ASN, BSN, RN · May 15, 2011

You cannot ignore them or the call bell as something maybe really wrong. But you can tell them that you will not fullfill certain tasks that they can do for themselves.

You can refuse to do as they ask.......inappropriate suggestions........sexual advances.......PLEASE! untie these restraints....... :smokin:

myk_RN · May 15, 2011

Ignoring the call bell is a NO-NO. But like whats been mentioned before, you can tell your patient that you wouldn't do petty things that they can do on their own. (in a good way of course)

Now, about the non-medical related requests, it really depends. As long as I'm not busy and the request is valid enough for me, I don't mind. A few examples of valid requests I can think of are back scratching, making a phone call, buying magazines/newspaper, buying a prepaid phone card, etc...

George4life · May 15, 2011

I have been know to tell some people that are being ridiculous that maybe we should start looking into long term care options. Usually results in a miraculous recovery.

lol that is a good ideal

thanks for replying

loriangel14, RN · May 15, 2011

Yes I have used the "who's going to do this for you when you go home?" line. Also the "gee maybe you will have to start considering long term care options" works well. One great option as well is make them get up out of bed and have them stay up ( usually wheelchairs and geri chairs out of their rooms so they are away from the bell.

nurseprnRN, BSN, RN · May 15, 2011

granted, there are some people whose anxiety levels are so high that they literally have to have the security of response all the time. you have to feel sorry for them, and there have been some non-snarky methods of behavior modification mentioned above. no, you cannot ignore a call light or request for help. remember the little dutch boy... well, one day the dike really was leaking. how would it be if you found out that something really bad had happened to someone because your floor staff had just ignored a call bell from a "frequent flyer"?

one thing that i see forgotten over and over again is that some patients really can't reach that phone, or get their water glass, or get a tissue. chronic lung failure patients are (in)famous for being "difficult," because "they never say thank you/get their own urinal even if it's within reach/wipe their own noses ..." etc.

the reason for this is simple: many of their nurses have no idea how much metabolic energy goes into breathing. answer is, normally, about 4%. that's four percent of all the work that all the cells in your body do-- growing your hair, pumping blood, making your brain think, making new skin and gut epithelium, moving electrolytes in and out of cells, making your glands secrete, digesting, breathing, growing new rbcs in your marrow, everything. in copd the %age of total body work that goes into breathing can go up to 25%. these people literally do not have enough breath to spare to say thank you. they desaturate very impressively with the effort of merely lifting an arm.they really do need you to place that urinal or move those tissues. part of the nurse's responsibility is to know things like this, so as to give the care needed to a given person.

ok